When the Minnesota legislature was debating a paid unwell leave bill last year, business owners he argued that such a law would not allow them to provide as many “benefits” or be as “custom” to employees as they claim they would be without such a requirement. But a half-dozen witnesses made the case for the need, and many employees shared examples of numerous times they had to work while unwell.
Maria Vazquez, a member of the Minneapolis union group, told lawmakers that she often feels too unwell to do her job as a housekeeper but cannot afford to miss work.
“There were many times when I came to work not only with a high fever, but to the point where my legs could barely support me, and people would ask me why I was working, and I had no choice because I couldn’t take sick leave,” Vazquez said.
The Earned Sick Time and Safe Work Time Act finally passed, and the law went into effect this month. Another law providing paid family and medical leave also passed last year, but goes into effect in January 2026. Minnesota joins 14 other states and the District of Columbia that now require paid unwell days. Meanwhile, 13 states and the District of Columbia provide paid family and medical leave, which provides more time off, According to KFF.
Pennsylvania, Pittsburgh, Philadelphia and Allegheny County have passed their own paid unwell leave laws.
Washington, which has had a paid unwell leave law since 2018, updated its law to include unwell time accrual for construction workers, recognizing that these workers may have multiple employers in a tiny period of time. The changes went into effect Jan. 1. California workers recently won an escalate in the number of paid unwell days employers must provide from three to five days. In July, Chicagoans will be able to get five unwell days every year.
Political momentum for paid unwell leave has continued in other states this year, and experts say it could eventually force the federal government to pass federal legislation as more people see the economic value of paid unwell leave.
Paid unwell leave advocates in AlaskaNebraska and Missouri are pushing referendum initiatives this year. The group Paid Sick Leave for Nebraskans wants full-time workers to get the minimum five to seven days paid unwell leave and for other workers to receive paid unwell leave as well. Missourians for Healthy Families and Fair Wages has launched a campaign for paid unwell leave and a higher minimum wage this year on the ballot in their condition. The amount of paid unwell time for employees correspond working hours and size of the employer.
Policy advocates and economists say the lack of paid unwell leave, which primarily affects the most vulnerable workers, forces workers to choose between financial stability and their own well-being and the health of their families and coworkers.
This problem is particularly urgent this month due to the pointed escalate in cases of respiratory viruses. According to The Centers for Disease Control’s Jan. 5 update on respiratory virus activity, which includes influenza, RSV and COVID-19, shows emergency room visits are “elevated across all age groups” and are rising except for school-age children. Wastewater levels, which indicate infections, are 27% higher. Hospitals are reporting an escalate in COVID-19, influenza and RSV cases, including Michigan, ohio, MarylandAND New Jersey.
COVID-19 is driving discussions
Molly Weston Williamson, a senior research fellow at the Women’s Initiative at the Center for American Progress, said the COVID-19 pandemic has played a role in the policy discussion about paid unwell leave.
“The pandemic has brought new attention to the need for paid sick leave, underscoring critical public health issues as well as the economic and human costs of the status quo — a need that has only been underscored by union actions like the rail workers’ fight for paid sick leave,” she said. “This has led to heightened policy attention, from temporary federal paid COVID leave in 2020 to new and expanded state and local protections.”
To improve these working conditions, some Democrats and labor advocates are advocating for legislation like the federal Healthy Families Act, which would create a national right to earn time off protected by work and provide a way to calculate accrued paid unwell time, and the FAMILY Act, which provides paid family and medical benefits. (The Family Medical Leave Act, or FMLA, which passed Congress in 1993 despite opposition from the business community, requires employers of a certain size to offer only unpaid family leave.)
The House of Representatives’ bipartisan working group on family leave released structure for paid leave legislative options, such as public-private partnerships for state-run programs and tax credits for paid family and medical leave. A federally funded paid leave program is not included in these options.
In the past, Republicans at the federal level have had he didn’t agree with Democrats on how to expand family and medical leave and how to fund it.
Sherry Leiwant, co-president and co-founder of A Better Balance, said the framework is a good step toward introducing more worker-friendly policies in Congress.
“Maybe Republicans are starting to realize this is really important to people.”
Leiwant said that as more states adopt paid unwell leave laws, businesses may realize they need more consistency, especially if they operate in different states.
Economic necessity
Data from the Economic Policy Institute clearly indicate the need for paid unwell days to stabilize the financial situation of employees report published in November. Compared with 63% of private-sector workers who had access to paid unwell days in 2010, 78% do now, and over the same period, the share of lowest-paid workers who had paid unwell days nearly doubled, the think tank found. The report’s authors also calculated what workers would give up in terms of housing, groceries, transportation and other necessities in exchange for unpaid unwell days.
“If you think about taking a leave without any assets or savings, that could have a very large impact on a family budget,” said Hilary Wething, an economist at the Economic Policy Institute and one of the authors of the report. “If a worker loses pay for taking, for example, five days off if they have RSV or their child has RSV, that could be their entire monthly grocery budget. If they take three days off, that could be their entire monthly utility budget, and two days could be their entire monthly gas budget, which could make it harder to get to work. You can see how a series of events could cascade for them and become a much bigger problem than it needed to be.”
Country Republican legislators AND business groups often argued that paid family leave and paid unwell time are a burden on businesses and can reduce employee benefits. But Wething said such arguments against paid unwell time are not supported by available research and that stability in both the health and finances of employees can also benefit employers.
“If we have a healthier workforce, we have a more productive workforce, and we have to remember that every sick employee can reduce the productivity of companies,” she said. “I think a federal mandate to allow more people to be able to get paid sick leave, essentially by having fewer people come to work sick, will have an impact on the economy more broadly from a public health perspective, which will be great for employers’ bottom lines.”
Williamson of the Center for American Progress said it is time for the federal government to learn from the impact of the COVID-19 pandemic and pass the Healthy Families Act.
“We know that paid sick leave works — for workers, for businesses, and for the health of our communities,” she said. “And yet, as we approach four years since a deadly pandemic hit our shores, at the federal level, the United States still does not guarantee a single day of paid sick leave.”
